EP1226800B1 - Constrained Prosthetic knee with rotating bearing - Google Patents
Constrained Prosthetic knee with rotating bearing Download PDFInfo
- Publication number
- EP1226800B1 EP1226800B1 EP02250512.7A EP02250512A EP1226800B1 EP 1226800 B1 EP1226800 B1 EP 1226800B1 EP 02250512 A EP02250512 A EP 02250512A EP 1226800 B1 EP1226800 B1 EP 1226800B1
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- EP
- European Patent Office
- Prior art keywords
- hinge post
- component
- extension
- hinge
- prosthetic knee
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Revoked
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3868—Joints for elbows or knees with sliding tibial bearing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/38—Joints for elbows or knees
- A61F2/3836—Special connection between upper and lower leg, e.g. constrained
- A61F2/384—Special connection between upper and lower leg, e.g. constrained hinged, i.e. with transverse axle restricting the movement
- A61F2/385—Special connection between upper and lower leg, e.g. constrained hinged, i.e. with transverse axle restricting the movement also provided with condylar bearing surfaces
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/0095—Packages or dispensers for prostheses or other implants
Definitions
- Bearing box 70 is designed for placement between condyler bearing surfaces 28, 30 of femoral component 22 as illustrated, e.g., in Figure 1 .
- Bearing box 70 is further illustrated in Figures 10-12 and includes affixing protrusions 72, hinge pin aperture 62, hyperextension stop 66, and anti-rotation surface 78.
- femoral component 22 includes affixing protrusion apertures 74 sized to receive affixing protrusions 72.
- Figure 1 illustrates bearing box 70 operably positioned on femoral component 22, with anti-rotation surface 78 flush with bearing box wall 76 of femoral component 22, and affixing protrusions 72 received in affixing protrusion apertures 74.
- FIG 20 illustrates a further alternative embodiment of the hinge post of the present invention.
- Hinge post 40c illustrated in Figure 20 includes reinforcing material 138 to strengthen hinge post 40c.
Description
- The present invention relates to prosthetic joints, and, more particularly to a constrained prosthetic knee having a modular hinge post and a rotating bearing.
- Generally, the knee is formed by the pair of condyles at the distal portion of the femur, the lower surfaces of which bear upon the correspondingly shaped proximal surface plateau of the tibia. The femur and tibia are connected by means of ligaments such as, the posterior cruciate ligament, the lateral collateral ligament, the medial collateral ligament, and the anterior cruciate ligament. These ligaments provide stability to the joint formed by the femur and tibia (i.e., the knee).
- In a broad sense, prosthetic knee joints can be considered either constrained or unconstrained. For the purposes of this discussion, constrained prosthetic knees include femoral and tibial prosthetic components which are mechanically linked or constrained to each other by a hinge structure. An unconstrained prosthetic knee includes femoral and tibial components which are not mechanically linked. An unconstrained knee utilizes the patient's existing ligaments to provide joint stability. With this in mind, constrained prosthetic knees have particular applicability to cases in which a patient has experienced ligament loss and/or the existing ligaments do not provide adequate support and stability to the knee.
- Tibial components of a prosthetic knee can be formed as a one-piece configuration in which the tibial tray forms the meniscal component of the prosthetic knee. Various other prosthetic knees utilize a modular meniscal component separate from the tibial component. Devices utilizing modular meniscal components include those in which the meniscal component (i.e., tibial bearing surface) is fixed to the tibial tray portion of the tibial component and is incapable of movement relative thereto. Alternative devices utilize a modular meniscal component capable of movement relative to the tibial tray. Devices in which relative rotational movement occurs between the meniscal component and the tibial component are typically referred to as rotating bearing knees. Rotating bearing knees thus allow movement between the bearing (i.e., meniscal component) and the tibial tray, as well as movement between the femoral component and the tibial bearing.
- Constrained knees of the prior art include constructions in which a hinge post extension is first positioned within a tibial component (with an end protruding therefrom) and is thereafter connected to the femoral component by positioning the hinge post (rotatably attached to the femoral component) over the top of the protruding end of the hinge post extension and thereafter connecting the hinge post extension to the hinge post, e.g., by threading the hinge post extension into the hinge post. After making this connection, the meniscal component is thereafter slid into position between the femoral component and the tibial component. Meniscal components utilized with these prior art prosthetic knees were fixed to the tibial component.
- An example of prior art devices is given in
EP-0 716 839 . - The present invention is directed to a constrained knee prosthesis with a rotating bearing. The knee prosthesis of the present invention is structured to facilitate implantation thereof. The present invention is further directed to a prosthetic knee implant set having a plurality of matched modular hinge post and meniscal component pairs.
- The present invention provides an improved constrained knee prosthesis having a cannulated hinge post facilitating implantation of the knee prosthesis in a relatively minimally invasive procedure. The prosthetic knee implant set of the current invention may include a separately packaged femoral component, a separately packaged tibial component, and a third package containing a hinge post extension and the meniscal component. Packaging the individual components of a knee prosthesis in this fashion insures that the appropriate hinge post extension is readily available. A bearing box is interposed between the hinge post and the femoral component. The bearing box includes a hyperextension stop which cooperates with the hinge post to prevent hyperextension of the knee prosthesis. Various structures are utilized to prevent the disengagement of the constrained knee prosthesis of the present invention.
- A prosthetic knee constructed in accordance with the present invention is described in
claim 1. - A prosthetic knee constructed in accordance with the present invention includes a femoral component having a pair of condyler surfaces and a hinge post rotatably connected to the femoral component between the condyler surfaces. The hinge post is cannulated and accommodates insertion of a hinge post extension shaft therein. The hinge post and hinge post extension include cooperating locking tapers for locking the hinge post extension to the hinge post. Additionally, the hinge post includes internal threads so that a set screw may be threaded therein to further hold the hinge post extension in place. The tibial component includes a hinge post extension aperture into which the hinge post is seated. The meniscal component similarly includes an aperture to accommodate the hinge post and hinge post extension. The meniscal component of the current invention is free to rotate about the hinge post during flexion and extension of the knee joint.
- Having a cannulated hinge post through which a hinge post extension may be anteriorly positioned and secured advantageously allows for a relatively minimally invasive knee replacement procedure.
- The present invention advantageously provides a constrained prosthetic knee having a rotating bearing flush with the condyler surfaces of the femoral component.
- Another advantage of the present invention is the packaging of the prosthesis components and specifically the packaging of the appropriate hinge post extension together with a meniscal component.
- The above-mentioned and other features and advantages of this invention, and the manner of attaining of them, will become more apparent and the invention itself will be better understood by reference to the following description of an embodiment of the invention taken in conjunction with the accompanying drawings, wherein:
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Figure 1 is a perspective view of an assembled knee prosthesis in accordance with the present invention; -
Figure 2 is an exploded view thereof; -
Figure 3 is a cutaway, exploded view illustrating assembly of the knee prosthesis of the current invention including the anterior positioning of the hinge post extension into the hinge post; -
Figure 4 is a cutaway view illustrating securement of the hinge plug (i.e., set screw) in the hinge post to facilitate locking of the hinge post extension therein; -
Figure 5 is a cutaway, exploded view illustrating removal of the hinge post extension; -
Figure 6 is a bottom elevational view of the meniscal component of the present invention; -
Figure 7 is a front elevational view thereof; -
Figure 8 is a top elevational view of a tibial component in accordance with the present invention; -
Figure 9 is a sectional view of a hinge plug in accordance with the present invention; -
Figure 10 is a side elevational view of a bearing box in accordance with the present invention; -
Figure 11 is a front elevational view thereof; -
Figure 12 is a top elevational view thereof; -
Figure 13 is a cutaway, exploded view of an alternative embodiment of the knee prosthesis of the present invention; -
Figure 14 is a cutaway view of an assembled knee prosthesis in accordance with the embodiment illustrated inFigure 13 ; -
Figure 15 is a fragmentary, cutaway view of an alternative embodiment of the hinge post extension and tibial bushing of the present invention; -
Figure 16 is a fragmentary, cutaway view of the embodiment ofFigure 15 illustrating insertion of the hinge post extension into the tibial bushing; -
Figure 17 is a fragmentary, cutaway view of the embodiment ofFigure 15 illustrating the hinge post extension fully inserted into the tibial bushing; -
Figure 18 is an exploded view of an alternative embodiment of the knee prosthesis of the current invention; -
Figure 19 is a sectional view of a meniscal component in accordance with an alternative embodiment of the present invention; and -
Figure 20 is an elevational view of a hinge post in accordance with an alternative embodiment of the present invention. - Corresponding reference characters indicate corresponding parts throughout the several views. Although the drawings represent embodiments of the invention, the drawings are not necessarily to scale and certain features may be exaggerated to better illustrate and explain the invention. The exemplifications set out herein illustrate embodiments of the invention, in alternative forms, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.
- Referring now to the drawings and particularly to
Figure 2 ,knee prosthesis 20 in accordance with the present invention is illustrated.Knee prosthesis 20 generally includesfemoral component 22,tibial component 24, andmeniscal component 26. Hinge post 40 is rotatably connected tofemoral component 22 and includes elongate hinge post extension aperture 112 (Figures 3-6 ,13, and 14 ).Elongate aperture 112 accommodates placement ofhinge post extension 42 therein.Hinge post extension 42 thereafter traverses hingepost aperture 114 inmeniscal component 26 and hinge post extension aperture 110 (Figures 3-6 ,13 and 14 ) intibial component 24. Elongate hingepost extension aperture 112 of hinge post 40 advantageously allows for anterior placement ofhinge post extension 42 during surgical implantation ofknee prosthesis 20 of the present invention. - As illustrated in
Figure 2 , hingepost extension 42 includes lockingtaper 46 andcylindrical extension 48. Hingepost extension aperture 112 includes a mating locking taper to cooperate with lockingtaper 46 and lock hingepost extension 42 to hingepost 40. After positioning ofhinge post extension 42 throughapertures hinge plug threads 54 inelongate aperture 112 of hinge post 40 (Figure 4 ).Hinge plug 38 abuts the end ofhinge post extension 42 and thereby facilitates locking of morse-taper 46 inelongate aperture 112. In one exemplary embodiment, lockingtaper 46 comprises a two degree locking taper. Whenprosthetic knee 20 is assembled as illustrated inFigure 1 , condyler bearing surfaces 28, 30 abut bearing surfaces 86, 88 (see, e.g.,Figure 2 ) inmeniscal component 26. -
Hinge post extension 42 is typically formed as a one-piece construction of an inert metal such, e.g., a cobalt-chromium alloy.Hinge post extension 42 may, however, be constructed of other bio-compatible metals or alloys, such as titanium. Throughout this document reference will be made to various components formed of a cobalt-chromium alloy. Any such component may also be constructed of other bio-compatible metals or alloys such as titanium, as is well-known. As illustrated inFigure 4 , hingeplug wrench 102 is utilized to thread hinge plug 38 intohinge plug threads 54 ofhinge post 40. As illustrated inFigure 9 , hingeplug 38 includes lockingmaterial 100 to provide a locking connection betweenhinge plug 38 and hingeplug threads 54 inhinge post 40.Hinge plug 38 is, in one exemplary embodiment formed of a cobalt-chromium alloy. Lockingmaterial 100 comprises any suitable biocompatible polymer such as, e.g., ultra-high molecular weight polyethylene (UHMWPE). - As illustrated, e.g., in
Figure 2 ,femoral component 22 includes condyler bearing surfaces 28, 30 with bearingbox wall 76 positioned therebetween.Femoral component 22 further includesexternal side walls 82, only one of which can be seen inFigure 2 . Condyler bearing surfaces 28, 30 are smooth and highly polished, generally spheroidally shaped and extend outwardly fromexternal side walls 82, as is well known in the industry.Femoral component 22 further includes modularfemoral stem 32 for insertion into femur 116 (Figures 3-5 ,13, and 14 ), as is known in the art.Femoral component 22 further includes internal side walls 80, only one of which is illustrated inFigure 2 . Internal side walls 80 are substantially perpendicular to bearingbox wall 76 and extend outwardly therefrom.Femoral component 22 is typically formed as a one-piece construction of an inert metal such as, e.g., a cobalt-chromium alloy. -
Bearing box 70 is designed for placement between condyler bearing surfaces 28, 30 offemoral component 22 as illustrated, e.g., inFigure 1 .Bearing box 70 is further illustrated inFigures 10-12 and includes affixingprotrusions 72,hinge pin aperture 62, hyperextension stop 66, andanti-rotation surface 78. As illustrated inFigure 2 ,femoral component 22 includes affixingprotrusion apertures 74 sized to receive affixingprotrusions 72.Figure 1 illustrates bearingbox 70 operably positioned onfemoral component 22, withanti-rotation surface 78 flush with bearingbox wall 76 offemoral component 22, and affixingprotrusions 72 received in affixingprotrusion apertures 74. The abutting relationship ofanti-rotation surface 78 with bearingbox wall 76 discourages rotation of bearingbox 70 about the longitudinal axis of affixingprotrusions 72. When bearingbox 70 is positioned onfemoral component 22,hinge pin apertures 62 of bearingbox 70 align with threadedhinge pin aperture 56 andhinge pin aperture 58 offemoral component 22.Bearing box 70 can be formed of any suitable plastic, such as, e.g., UHMWPE. - Hinge post 40 is rotatably connected to
femoral component 22 viahinge pin 34. Hinge post 40 is placed between opposing walls of bearingbox 70 and is positioned so thathinge pin aperture 52 is aligned withapertures box 70 thus act as a bearing surface betweenhinge post 40 and internal side walls 80 offemoral component 22. Prior to placement of hinge post 40 between opposing walls of bearingbox 70,hinge pin sleeve 36 is operably positioned withinhinge pin aperture 52 ofhinge post 40. Hinge post 40 is formed from a cobalt-chromium alloy, whilehinge pin sleeve 36 is formed from a suitable plastic, such as, e.g. UHMWPE.Hinge pin sleeve 36 acts as a bearing betweenhinge pin aperture 52 ofhinge post 40 andhinge pin 34. Accordingly,hinge pin sleeve 36 includeshinge pin aperture 50 sized to accommodatehinge pin 34. After positioning of hinge post 40 between the opposing walls of bearingbox 70,hinge pin 34 is positioned throughapertures Hinge pin threads 60 are thereafter threadedly engaged in the threads of threadedhinge pin aperture 56 until the head ofhinge pin 34 is flush withexternal side wall 82. - As illustrated in
Figure 1 ,hinge pin plug 120 is positioned within the hexagonal indentation ofhinge pin 34 after installation ofhinge pin 34 as described above. When positioned within the hexagonal indentation ofhinge pin 34,hinge pin plug 120 is flush with the head ofhinge pin 34. In use,hinge pin plug 120 substantially prohibits the entry of foreign materials into the hexagonal indentation ofhinge pin 34. For example,hinge pin plug 120 substantially prohibits bone growth into the hexagonal indentation ofhinge pin 34, as well as prohibiting positioning of bone cement therein. The above-described connection of hinge post 40 tofemoral component 22 is performed prior to implantation offemoral component 22.Femoral component 22 is packaged and sold with bearingbox 70, hingepost 40,hinge pin sleeve 36,hinge pin 34, and hingepin plug 120 preassembled as described above, with the assembly preferably occurring in the manufacturing environment. - Pre-assembly of hinge post 40 to
femoral component 22 eliminates a number of meticulous assembly steps (many of which were performed during implantation) which were required with constrained knees of the prior art. Furthermore, the assembly ofhinge post 40 andfemoral component 22 as described above facilitates replacement of various portions ofknee prosthesis 20. Specifically, the threaded connection ofhinge pin 34 tofemoral component 22 allows for removal and replacement of various components ofknee prosthesis 20 including, e.g., bearingbox 70,hinge pin sleeve 36, and hingepost 40. - In use, femoral bone stock may abut
external side walls 82 offemoral component 22 and extend to the underside of condyler bearing surfaces 28, 30. To removehinge pin 34, a hole saw is utilized to remove a relatively small portion of femoral bone stock to provide access to hingepin 34. Advantageously,femoral component 22 does not require extensive removal of femoral bone stock for implantation thereof (since bone stock can extend to the underside of condylar bearing surfaces 28, 30), and, furthermore, does not require removal offemoral component 22 to effect replacement of, e.g., hingepost 40, bearingbox 70, or hingepin sleeve 36. Upon accessing hinge pin 34 (e.g., utilizing a hole saw as described above),hinge pin plug 120 is removed, e.g., with a scalpel and forceps to provide access to the hexagonal indentation ofhinge pin 34 so that a hexagonal wrench may be inserted therein to unthreadhinge pin 34 fromfemoral component 22. -
Knee prosthesis 20 includes a pair of hyperextension stop mechanisms. The first hyperextension stop comprises a portion of condylar bearing surfaces 28, 30 of increased radius of curvature as compared to the remaining condylar bearing surface. At three degrees of hyperextension this portion of increased radius of curvature will contactmeniscal component 26 and act to retard further hyperextension. If hyperextension continues, the area of increased radius of curvature will causefemoral component 22 to lift away frommeniscal component 26. The second hyperextension stop mechanism functions at four degrees of hyperextension to prohibit further hyperextension ofknee prosthesis 20. The second hyperextension stop mechanism compriseshyperextension stop surface 66 ofhinge post 40 and hyperextension stop 68 of bearingbox 70.Hyperextension stop surface 66 comprises the concave back wall of cannulatedhinge post 40 as illustrated, e.g., inFigures 2 and3 . Hyperextension stop 68 of bearingbox 70 comprises a protrusion extending from the back wall of bearingbox 70opposite anti-rotation surface 78. Hyperextension stop 68 includes a convex outer surface as illustrated, e.g., inFigure 12 .Hyperextension stop surface 66 ofhinge post 40 cooperates with hyperextension stop 68 of bearingbox 70 to provide a hyperextension stop forknee prosthesis 20. Concave hyperextension stopsurface 66 becomes flush with the convex outer surface of hyperextension stop 68 of bearingbox 70 at four degrees of hyperextension to prevent further hyperextension ofknee prosthesis 20. -
Tibial component 24 is depicted inFigures 1-5 ,8 ,13, and 14 . As illustrated, e.g., inFigure 2 ,tibial component 24 includestibial tray 98 connected totibial stem 92. Stabilizingribs 94 stabilizetibial tray 98 relative totibial stem 92 and impede rotation oftibial component 24 in tibia 118(see, e.g.,Figures 3 ). In one exemplary embodiment,tibial component 24 is formed from a cobalt-chromium alloy.Tibial component 24 further includestibial bushing 64 positioned within hingepost extension aperture 110.Tibial bushing 64 is formed of plastic, such as, e.g., UHMWPE and provides a bearing surface betweenhinge post extension 42 and hingepost extension aperture 110 oftibial component 24. As described above,meniscal component 26 comprises a rotating bearing, and, thus, hingepost extension 42 will rotate relative totibial component 24.Tibial bushing 64 facilitates this rotation ofhinge post extension 42. -
Tibial component 24 further includesrotation protrusion 96. As illustrated, e.g., inFigure 3 ,rotation protrusion 96 protrudes upwardly fromtibial tray 98 oftibial component 24 and further extends in a plane substantially parallel totibial tray 98.Rotation protrusion 96 cooperates withcutout 90 ofmeniscal component 26 to guide rotation ofmeniscal component 26 abouthinge post extension 42, as further described hereinbelow. - One embodiment of
meniscal component 26 is illustrated inFigures 1-7 ,13, and 14 .Meniscal component 26 is formed from a suitable plastic such as, e.g., UHMWPE and provides a rotating bearing surface betweenfemoral component 22 andtibial component 24.Meniscal component 26 includes bearing surfaces 86, 88 which contact condylar bearing surfaces 28, 30 offemoral component 22 during movement ofknee prosthesis 20. As described above,meniscal component 26 further includeshinge post aperture 114 accommodating passage ofhinge post 40 and, consequently, hingepost extension 42 therethrough.Meniscal component 26 is operable to rotate about the longitudinal axis ofhinge post extension 42 to form a rotating bearing. - Meniscal components of varying heights may be constructed in accordance with the present invention. In one advantageous aspect of the present invention,
meniscal component 26 is package for sale and use together withhinge post extension 42 to facilitate component choice and, in one embodiment, to ensure proper extension ofhinge post extension 42 intotibial component 24. The extension ofhinge post extension 42 intotibial component 24 functions to prevent separation ofknee prosthesis 20 after implantation thereof. As is known in the art, the femoral component of a knee prosthesis may, in some situations, move relative to and away from the tibial component in a direction parallel to the longitudinal axis of the hinge post extension. With this in mind, hingepost extension 42 is made to be of sufficient length to be retained withintibial component 24 even in situations in whichfemoral component 22 moves as described immediately supra. In one exemplary embodiment, hingepost extension 42 extends four centimeters into hingepost extension aperture 110 intibial component 24. -
Meniscal component 26 includescutout 90 which cooperates withrotation protrusion 96 oftibial component 24 to guide rotation ofmeniscal component 26 and to resist lifting ofmeniscal component 26 fromtibial tray 98 oftibial component 24. As illustrated, e.g., inFigure 3 ,cutout 90 accommodates the portion (i.e., lip) ofrotation protrusion 96 extending in a plane substantially parallel to the plane containingtibial tray 98, with a portion (i.e., lip) ofmeniscal component 26 being positioned betweenrotation protrusion 96 andtibial tray 98 in a direction substantially perpendicular to the plane containingtibial tray 98. This configuration functions to discourage displacement ofmeniscal component 26 away fromtibial tray 98 in a direction parallel to the longitudinal axis ofhinge post extension 42. Furthermore,rotation protrusion 96 acts against the back ofcutout 90 to limit rotation ofmeniscal component 26 about the longitudinal axis ofhinge post extension 42. - As illustrated in
Figure 5 ,meniscal component 26 may be slid out from betweentibial component 24 andfemoral component 22 when thehinge post extension 42 has been removed fromknee prosthesis 20. As illustrated, hingepost aperture 114 is sized to allow rotation of hinge post 40 so thatmeniscal component 26 may be slid out from its position betweenfemoral component 22 andtibial component 24. This configuration allows for replacement of an implantedmeniscal component 26 without requiring removal ofhinge post 40.Figure 5 illustrates removal ofhinge post extension 42 to accommodate replacement ofmeniscal component 26. As illustrated, hingeplug wrench 102 engageshinge plug 38 for removal thereof. After removal ofhinge plug 38,slap hammer 104 is threadedly engaged with threadedaperture 44 inhinge post extension 42.Slap hammer 104 may then be utilized to unlock the engagement of lockingtaper 46 in elongate hingepost extension aperture 112 so thathinge post extension 42 may be removed. -
Figures 13 and 14 illustrate an alternative embodiment of the knee prosthesis of the current invention. This alternative embodiment utilizes hingepost extension 42a having lockingtaper 46a,cylindrical extension 48a, andflange 106. In this embodiment, a locking instrument may be utilized to apply force atophinge post extension 42a so that lockingtaper 46a is seated in elongate hingepost extension aperture 112 and locked therein.Flange 106 may be utilized to facilitate removal ofhinge post extension 42a. As illustrated inFigure 13 , setscrew 108 may be utilized as a secondary lock forhinge post extension 42a. In all other respects, the knee prosthesis illustrated inFigures 13 and 14 is constructed as described above with respect to the first embodiment of the knee prosthesis in accordance with the present invention. -
Figures 15, 16 and 17 illustrate an alternative embodiment of the hinge post extension and tibial bushing of the present invention. In this embodiment,tibial component 24a includes annular tibialbushing expansion groove 122 formed in hingepost extension aperture 110.Tibial bushing 64a includes retainingflange 130 positioned within annular tibialbushing expansion groove 122.Figure 15 illustrates insertion ofcylindrical extension 48b of the hinge post extension intotibial bushing 64a positioned withintibial component 24a. Ascylindrical extension 48b proceeds intotibial bushing 64a, bevel 126 contacts annular lockingprotrusion 128 oftibial bushing 64a and causes outward movement of retainingflange 130 to allowcylindrical extension 48b to proceed to its seated position as illustrated inFigure 17 . Annular tibialbushing expansion groove 122 is sized to allow radial expansion of retainingflange 130 to accommodate placement ofcylindrical extension 48b withintibial bushing 64a. In the fully seated position (Figure 17 )cylindrical extension 48b is locked in place by the engagement ofannular locking protrusion 128 inannular locking groove 124. Furthermore, retainingflange 130 cooperates with annular tibialbushing expansion groove 122 to prohibit axial displacement oftibial bushing 64a and, consequently,cylindrical extension 48b. In this embodiment, the femoral component is retained in abutting relationship to the meniscal component and lift off of the femoral component is substantially prohibited.Tibial bushing 64a is, in one exemplary embodiment, formed of UHMWPE -
Figures 18 and 19 illustrate another alternative embodiment of the knee prosthesis of the current invention. In this embodiment, lockingclip 134 is utilized to retain the position ofhinge post 40b withinhinge post aperture 114 ofmeniscal component 26a.Hinge post 40b is rotatably attached tofemoral component 22 utilizinghinge pin 34 as described above. In this embodiment, hingepost 40b includes lockingclip grooves 132, andmeniscal component 26a includes lockingclip apertures 136. Upon positioning ofhinge post 40b withinhinge post aperture 114, lockingclip 134 is positioned as illustrated inFigure 19 with each prong of lockingclip 134 being inserted into lockingclip apertures 136 ofmeniscal component 26a. As illustrated inFigure 19 , lockingclip 134 engages lockingclip grooves 132 to retainhinge post 40b withinhinge post aperture 114 ofmeniscal component 26a. In this embodiment, lift off offemoral component 22 is prohibited by the engagement ofhinge post 40b withmeniscal component 26a. This embodiment of the knee prosthesis of the current invention may further utilize a meniscal component cutout together with a rotation protrusion on the tibial component to resist lifting of the meniscal component from the tibial tray as described above. -
Figure 20 illustrates a further alternative embodiment of the hinge post of the present invention.Hinge post 40c illustrated inFigure 20 includes reinforcingmaterial 138 to strengthenhinge post 40c. - While this invention has been described as having exemplary designs, the present invention may be further modified within the scope of the appended claims.
Claims (13)
- Prosthetic knee (20), comprising:a femoral component (22);a tibial component (24);a hinge post device (40, 42) for rotatably connecting said femoral component (22) to said tibial component (24), said hinge post device (40, 42) being rotatably connected to the femoral component (22) about a rotational axis and extending into the tibial component (24);a meniscal component (26) positioned between said femoral component (22) and said tibial component (24), said femoral component (22) including a condylar bearing surface (28, 30), and said meniscal component (26) including a cooperative bearing surface (86, 88) facing said condylar bearing surface (28, 30) of said femoral component (22);wherein the meniscal component (26) forms a rotating bearing which allows rotational movement between the meniscal component (26) and the tibial component (24) about a longitudinal axis;wherein the femoral component (22) comprises external side walls (82) and the condylar bearing surface of the femoral component (22) comprises a pair of condylar surfaces (28, 30) extending outwardly from the external side walls (82), the hinge post device (40, 42) being rotatably connected to the femoral component (22) between the condylar surfaces (28, 30) of the femoral component (22) such that the rotational axis extends between the external sidewalls (82) where in use femoral bone stock may abut external side walls (82) and extend to the underside of condylar surfaces (28, 30); andwherein the longitudinal axis is defined by the hinge post device (40, 42), characterized in that the longitudinal axis is positioned anteriorly with respect to the rotational axis such that the longitudinal axis is positioned in the anterior part of the prosthetic knee, in particular of the femoral component (22).
- Prosthetic knee according to claim 1,
wherein the meniscal component (26) is free to rotate about the hinge post device (40, 42) during flexion and extension. - Prosthetic knee according to any of the preceding claims,
wherein said hinge post device (40, 42) is modular,
in particular wherein said hinge post device comprises a hinge post (40) rotatably connected to said femoral component (22) about the rotational axis and a hinge post extension (42) extending into the tibial component (24). - Prosthetic knee according to claim 3,
wherein the meniscal component (26) may be slid out from its position between the femoral component (22) and the tibial component (24) when the hinge post extension (42) is removed,
and/or wherein the meniscal component (26) includes a hinge post aperture (114), whereby the hinge post (40) is positioned within said hinge post aperture (114) when the prosthetic knee is operably assembled, the meniscal component (26) being rotatable about a longitudinal axis of said hinge post (40),
in particular wherein said hinge post aperture (114) is sized to allow rotation of the hinge post (40) so that the meniscal component (26) may be slid out from its position between the femoral component (22) and the tibial component (24) when the hinge post extension (42) is removed. - Prosthetic knee according to claim 3 or 4,
wherein the hinge post (40) includes a passage (112) for the hinge post extension (42), said passage (112) extending perpendicular to the rotational axis,
in particular wherein the passage (112) of the hinge post (40) is for positioning and securing the hinge post extension (42). - Prosthetic knee according to any of claims 3 to 5,
wherein the hinge post (40) is cannulated, and/or
wherein the hinge post (40) accommodates insertion of a hinge post extension shaft. - Prosthetic knee according to any of claims 3 to 6,
wherein the hinge post extension (42) is adapted to be inserted through the hinge post (40) and the meniscal component (26) into the tibial component (24) in a proximal-to-distal direction, and to be removed in a distal-to-proximal direction. - Prosthetic knee according to any of claims 3 to 7,
wherein the hinge post (40) includes an elongate hinge post extension aperture (112) sized for placement of said hinge post extension (42) therein, whereby said hinge post extension (42) traverses a first end of said hinge post extension aperture (112) and protrudes from a second end of said hinge post extension aperture (112) when operably positioned therein, said first and said second ends of said hinge post extension aperture (112) comprising opposing ends of said elongate hinge post extension aperture (112),
the tibial component (24) including a second hinge post extension aperture (110), whereby said hinge post extension (42) is positioned within said second hinge post extension aperture (110) when the prosthetic knee is operably assembled. - Prosthetic knee according to any of claims 3 to 8,
wherein the hinge post extension (42) is positioned anteriorly, in particular wherein the hinge post extension (42) is anteriorly positioned in the hinge post (40). - Prosthetic knee according to any of claims 3 to 9,
wherein the hinge post (40) and hinge post extension (42) include cooperating locking tapers (46) for locking the hinge post extension (42) to the hinge post (40),
in particular wherein the hinge post (40) has a hinge post extension aperture (112), the hinge post extension (42) has a locking taper (46) and a cylindrical extension (48), and the locking taper (46) is adapted to be seated in the hinge post extension aperture (112) and locked therein. - Prosthetic knee according to any of the preceding claims,
wherein a bearing box (70) is interposed between the hinge post device (40, 42) and the femoral component (22),
in particular wherein the bearing box (70) is designed for placement between condylar bearing surfaces (28, 30) of the femoral component (22),
and/or wherein the bearing box (70) has opposing walls between which the hinge post device (40, 42) is placed, and wherein the opposing walls of the bearing box (70) act as a bearing surface between the hinge post device (40, 42) and internal side walls (80) of the femoral component (22). - Prosthetic knee according to claim 11,
wherein the bearing box (70) includes a hyperextension stop (68) which cooperates with the hinge post device (40, 42) to prevent hyperextension of the prosthetic knee,
in particular wherein the hinge post device (40, 42) includes a hyperextension stop surface (66), said hyperextension stop (68) of the bearing box (70) contacting said hyperextension stop surface (66) to prevent further hyperextension of the prosthetic knee beyond a predetermined point of hyperextension. - Prosthetic knee according to any of the preceding claims,
wherein the meniscal component (26) is flush with the condylar bearing surface (28, 30) of said femoral component (22).
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP10012581A EP2272468B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP04012041.2A EP1447060B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP10012582.2A EP2272469B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/771,061 US6485519B2 (en) | 2001-01-29 | 2001-01-29 | Constrained prosthetic knee with rotating bearing |
US771061 | 2001-01-29 |
Related Child Applications (5)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP10012582.2A Division-Into EP2272469B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP10012582.2A Division EP2272469B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP04012041.2A Division EP1447060B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP04012041.2A Division-Into EP1447060B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP10012581A Division-Into EP2272468B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
Publications (3)
Publication Number | Publication Date |
---|---|
EP1226800A2 EP1226800A2 (en) | 2002-07-31 |
EP1226800A3 EP1226800A3 (en) | 2004-01-07 |
EP1226800B1 true EP1226800B1 (en) | 2014-07-02 |
Family
ID=25090569
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP10012581A Expired - Lifetime EP2272468B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP02250512.7A Revoked EP1226800B1 (en) | 2001-01-29 | 2002-01-25 | Constrained Prosthetic knee with rotating bearing |
EP04012041.2A Expired - Lifetime EP1447060B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP10012582.2A Expired - Lifetime EP2272469B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP10012581A Expired - Lifetime EP2272468B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP04012041.2A Expired - Lifetime EP1447060B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
EP10012582.2A Expired - Lifetime EP2272469B1 (en) | 2001-01-29 | 2002-01-25 | Constrained prosthetic knee with rotating bearing |
Country Status (5)
Country | Link |
---|---|
US (2) | US6485519B2 (en) |
EP (4) | EP2272468B1 (en) |
JP (1) | JP4205346B2 (en) |
AU (1) | AU780963B2 (en) |
CA (1) | CA2367652C (en) |
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EP2272468A2 (en) | 2011-01-12 |
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EP1447060B1 (en) | 2013-11-06 |
EP1226800A2 (en) | 2002-07-31 |
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